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Bunionectomy with Proximal Metatarsal Osteotomy

How would you code a bunionectomy with proximal metatarsal osteotomy and soft tissue release? I was thinking CPT 28295 and 28313 but wasn’t sure if this was correct.

Thanks in advance.

The foot exsanguinated and the tourniquet inflated. A classic Mann style distal soft tissue release was done and then a proximal osteotomy of the 1st metatarsal using the Mau osteotomy with the PROMO system. An excellent correction was obtained. Fixation was with the plate and the additional 3.0 mm lag screw. Partial resection of the medial eminence was done and medial capsule plication done too. Closure done with the tourniquet deflated. The adductor hallucis tendon sutured to the medial eminence.

Medical Billing and Coding Forum

bunionectomy

hi

a doctor performed an midshaft osteotomy at the metaphyseal/diaphyseal region of the left first metatarsal. I can’t decide between cpt codes 28295 or 28296. From reading different articles the diaphyseal region is the shaft (body) of the bone and the metaphyseal region is near the base. she also writes that the apex of the osteotomy pointed distally. diagnosis is hallux valgus

Thank you everyone for your input.

Medical Billing and Coding Forum

Tarsometatarsal Fusion with Bunionectomy (28740 & 28292)

Hi,

I have found three threads on here relating to this, but for the most part they are regarding fusion of the 1st metatarsal cuneiform joint with the bunion repair, which I understand is indeed included in the bunion repair.

I have read a few reports on how tarsometatarsal joint fusion can indeed be billed separately if it is for a separate issue. (hypermobile joint, arthritis) But, they are not from a reputable site. And I have also seen someone quote modifier 59 as stating that a separate diagnosis is not appropriate use of modifier 59.

Is there any documentation out there that specifically states that you cannot bill fusion of the TMT joint (28740) with 28292 and not just fusion of the 1st metatarsal cuneiform?

My providers strongly feel that this is the case, that TMT is separate.

Thank you,
Kelly Lilly

Medical Billing and Coding Forum